Dynamic Hip Screw with Trochanteric Stabilization Plate Fixation of Unstable Intertrochanteric Fractures

Document Type : Original Article

Authors

1 Department of Orthopedic Surgery, Al Hilal Hospital, Ministry of Health, Cairo, Egypt

2 Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt

Abstract

Background: Unstable trochanteric fractures carry a higher risk of implant failure and complications and are extremely challenging to treat. The intramedullary nail and dynamic sliding hip screw were the preferred implants for many years. However, these techniques were related to high failure rates.
Aim of the Study: This study aimed to assess the efficacy and safety of dynamic hip screw [DHS] with trochanteric stabilizing plate [TSP] in the fixation of unstable trochanteric fractures.
Patients and Methods: A prospective study was conducted on 20 patients with an unstable trochanteric fracture. The fractures were fixated using a DHS with TSP. All patients were followed up for 6 months to evaluate time to union, weight bearing ability, Parker Mobility Score [PMS], muscle power grade [ASIA], and incidence of complications. Radiological evaluation was performed preoperatively and during follow-up.
Results: The age of the included patients was 62.5±4.5 years. Most of the included patients had osteoporotic bone. Time to full bone union was 15.1±3.8 weeks. Time to partial weight bearing was after 6.9±1.5 weeks. Parker’s score was 7.85±1.089. The ASIA score was 4.10±0.788. Most cases [55%] had a tip-apex distance [TAD] less than 25 mm, and [45%] cases had TAD more than 25 mm. All patients with TAD less than 25 mm had early weight bearing and showed full union within three months.
Conclusion: For unstable intertrochanteric femoral fractures, the use of DHS with TSP fixation is a successful method that offers good functional and radiological outcomes with few complications and early rehabilitation rates.

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